- Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
- Assesses member compliance with medical treatment plans via telephone or through on-site visits.
- Identifies barriers to plan compliance and coordinates resolutions.
- Identifies opportunities that impact quality goals and recommends process improvements.
- Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
- Coordinates identification of and referral to local, state or federally funded programs.
- Coaches members on ways to reduce health risks.
- Prepares reports to document case and compliance updates.
- Establishes and maintains relationships with agencies identified in appropriate contract.
- Serves as a team lead.
- Participates in cross-functional teams on projects, initiatives, and process improvement activities.
- Requires a high school diploma and 5 years of related experience; or any combination of education and experience which would provide an equivalent background.
- Certified nurse assistant or certified medical assistant preferred and/or BS/BA degree in a related field preferred.
- Bilingual candidates preferred.
- Knowledge of behavioral health and physical health conditions preferred.
- Experience with electronic health records preferred.
- For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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outreach care specialist lead - S Indiana Ave, Bloomington, IN , USA, United States - Elevance Health
Description
Outreach Care Specialist LeadLocation:
This is a community, field based position in Indianapolis, IN. Ideal candidates will reside in Marion county, Indiana.
The Outreach Care Specialist Lead is responsible for ensuring that appropriate member treatment plans are followed on the most complex cases and for proactively identifying ways to improve the health of our members and meet quality goals.
How you will make an impact:
Minimum Requirements:
Preferred Skills, Capabilities, and Experiences:
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler.
We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates.
They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week.
Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.